The objective of this proposal is to determine the optimal means of detection, incidence, etiology, clinical and laboratory features and effects of treatment of human zinc deficiency in the pregnant woman, infant and growing child. Individual protocols include: the effects of zinc supplementation in pregnancy or biochemical indices of zinc nutriture; the effect of alcohol abuse on zinc status in pregnancy; maternal and amniotic fluid zinc status in relation to neural tube defects; zinc balance in premature infants fed human milk from their own mother; urine zinc excretion in high risk infants; the effects of zinc supplementation on physical growth rates of infants and children who have biochemical evidence of zinc depletion; the zinc status of infants with failure to thrive; zinc nutrition/metabolism in selected diseases (chronic neonatal liver disease; congenital heart disease; diabetes mellitus; phenylketonuria; chronic inflammatory bowel disease; cystic fibrosis); the pathogenesis and treatment of acrodermatitis enteropathica and other severe zinc deficiency syndromes; zinc bioavailability studies. Procedures to be used in this proposal will include; determination of zinc in plasma, hair, urine, parotid and mixed saliva and diets; the effects of topical zinc on delayed hypersensitivity; plasma zinc response to pharmacological doses of oral zinc; stable zinc isotope studies; gel chromatography and mass spectrometry analysis of zinc containing fractions from human milk and duodenal juice.